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What are the most (cost-) effective ways to prevent and control communicable diseases in prison settings? In their joint public health Guidance published today, ECDC and the EMCDDA present the evidence on active case finding as a key measure to diagnose communicable diseases early. The two agencies advise to actively offer testing for hepatitis B, hepatitis C and HIV to all people in prison and to conduct universal testing for tuberculosis at prison entry.

The Guidance provides scientific advice on different options for active case finding among people in prison in order to diagnose a range of communicable diseases early. For this, ECDC and the EMCDDA systematically retrieved and assessed the evidence on the effectiveness of active case finding interventions for blood-borne viruses, sexually transmitted infections and tuberculosis in prison settings in the European Union and European Economic Area.

Interrupting transmission with test-and-treat approach

Compared to the general public, people in prison have a higher burden of communicable diseases such as hepatitis B (HBV), hepatitis C (HCV) and HIV, syphilis, gonorrhoea, chlamydia and tuberculosis (TB). This constitutes a health risk for those living, and working, in prison settings as well as for the general population, given that the majority of people in prisons return to their communities after a short period of incarceration (median length of detention in Europe is less than nine months).

The ECDC–EMCDDA Guidance is based on consultations with a panel of prison experts, and identifies the most (cost-) effective approaches with the aim to interrupt transmission in, and between, prison settings as well as the community, by first testing and then offering treatment to those infected.

ECDC and the EMCDDA welcome the efforts of European Hepatitis-HIV Testing Week[4] to increase positive dialogue among those who might benefit from being tested and those who offer tests across Europe. The first spring edition of European Testing Week is currently underway (18–25 May 2018).